- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,890.91 / $18,563.00 / $31,088.60
| Facility | | $8,890.91 | $18,563.00 | $31,088.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,989.41 / $31,146.84 / $40,387.86
| Facility | | $20,989.41 | $31,146.84 | $40,387.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,648.00 / $24,949.04 / $39,890.87
| Facility | | $14,648.00 | $24,949.04 | $39,890.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,987.53 / $26,877.37 / $56,362.69
| Facility | | $13,987.53 | $26,877.37 | $56,362.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,865.96 / $9,865.96 / $9,865.96
| Facility | | $9,865.96 | $9,865.96 | $9,865.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,646.00 / $26,699.88 / $39,900.73
| Facility | | $17,646.00 | $26,699.88 | $39,900.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,281.00 / $18,358.56 / $34,317.10
| Facility | | $5,281.00 | $18,358.56 | $34,317.10 |